Best Care

Minnesota’s best hospitals and clinics constantly strive to bring more compassion to their care. Not only do these groups employ cutting-edge tools and techniques, but they regularly improve their health-care processes.

By Erin Peterson

Published: September 19, 2013

Jeff Johnson

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20 Important Advances at Top Local Hospitals & Clinics

Problem: Managing pain in kids is a particularly tricky proposition, given that younger children may have trouble communicating the extent of their pain (making both diagnosis and treatment difficult), and by the fact that many physicians are not trained in the latest methods on how to properly dose and medicate children.

New Approach: In 2013, Children's Hospitals and Clinics of Minnesota launched the state's only “no needless pain” initiative through its Pediatric Pain and Palliative Care program, which is one of the largest of its kind among children's hospitals in North America. The initiative’s “Open Pain Policy” allows parents, patients, relatives, and nurses—not just physicians—to request a pain-team consult. The team, which may include physicians, nurses, pharmacists, psychologists, child-life specialists, integrative-medicine staff, and social workers, can suggest an array of conventional and alternative approaches to pain management, from guided imagery to patient-controlled analgesic medications. An array of additional options, including conscious-sedation methods and techniques to numb skin for blood draws and IV therapies, are specifically designed to prevent and diminish pain in children.

Payoff: Kids heal faster and more comfortably—and parents regain a bit of control over the health of their children.

Blood Pressure

Problem: Few health numbers are tracked more consistently than our blood pressure—nearly every office visit includes the arm-mashing procedure. Yet for all its ubiquity, getting an accurate reading is surprisingly elusive. Not only can the numbers spike when we’re sitting anxiously in the exam room, but the most accurate readings occur while asleep.

New Approach: Ambulatory Blood Pressure Monitoring (ABPM), a procedure that monitors patients’ blood pressure away from the office over the course of a 24-hour period, can assess blood pressure more accurately. Though this option is typically only available to those seeing a specialist, physicians at Abbott Northwestern General Medicine Associates in Edina began offering the service at their primary-care clinic in 2012.

Payoff: Of the thousand or so patients who have had their blood pressure monitored through ABPM at Abbott, 30 percent have had results that required an adjustment of their medication levels.

Communication

Problem: Doctors and patients may have the same overarching goal, but they often speak different languages. Patients who misunderstand doctors’ guidance can end up doing a serious disservice to their own health.

New Approach: The Mayo Clinic is one of a small number of hospitals nationwide where some doctors read clinical notes to patients at the end of a visit to ensure both parties are on the same page about care and next steps. A simple miscommunication about the seriousness of a condition, for example, might lead to patients being cavalier about adhering to their specific care instructions. Going through the notes helps prevent confusion.

Payoff: Though Mayo Clinic hasn’t yet collected data on its own outcomes, a 2012 study from hospitals in three cities with similar practices revealed that the vast majority of patients reported more control and understanding of their conditions, and 99 percent of patients thought this transparency was the right approach for medical care.

Stroke

Problem: Strokes are common—but they’re also deviously complex. In rural areas and small towns, the right subspecialist may live hours away. That can be devastating in these critical situations when every second counts.

New Approach: The HealthEast Telestroke Program at St. Joseph’s in St. Paul, the first of its kind in Minnesota, links other small and medium-size HealthEast hospitals with St. Joseph’s stroke neurologists, who virtually monitor details and provide evaluation and treatment. Consulting neurologists communicate with patients through a live video feed, which allows them to run through a series of speech and motion assessments. The system also gives neurosurgeons a detailed look at CT scans.

Payoff: Stroke patients outside major cities don’t need to be immediately transferred to larger hospitals to get the best possible care.

Take One Tablet and Call Us In the Morning

You may have thought iPads were mainly for watching cat videos and playing all 425 levels of Candy Crush Saga, but the technology also is having a big impact on the medical care we receive.

For new moms: At St. Luke’s Birthing Center in Duluth, new moms and their families can check out iPads during their stay. Not only can the tablets be used to watch educational programming on breastfeeding and newborn care, but moms can use them to Skype faraway family members and friends who want a real-time look at the new bundle of joy. A pre-loaded white-noise app disguises hospital noise to help new moms rest.

For heart-failure patients: The CentraCare Heart & Vascular Center at St. Cloud Hospital is the first in the country to lend out iPads with specific applications to heart-failure patients. The application helps them monitor their symptoms and weight, and offers daily tips; it also has an alarm to remind patients to take their medication at specific times. According to Dona Bloch, a cardiology-practice nurse at CCHVC, the technology and software makes a difference. “[Heart-failure patients] need to make many lifestyle changes,” she says. “This helps them get positive feedback, and it also helps us know that they are compliant.”

For information junkies: Through Minnesota startup Clear.md, patients can get “vidscriptions”: short, single-topic videos from doctors about their specific conditions and concerns. The videos are designed to give reliable information to patients who can’t always take in the vast amounts of information given at a single doctor’s appointment and don’t want to depend on unreliable information from the Internet. North Memorial was the first hospital in the country to partner with Clear.md for the service.